Among RFs and their biomarkers, apoA-I, apoB and the apoB/apoA-I ratio showed strong association with ultrasound indicators of carotid atherosclerosis in IS patients.
A patent foramen ovale has been reported to be more frequently detected in cryptogenic stroke, with paradoxical embolism as the major pathogenetic mechanism. The standard procedure for the detection of a patent foramen ovale is transesophageal echocardiography. Transcranial Doppler sonography with bubble test is almost as reliable as transesophageal echocardiography. Seventeen patients with acute ischemic stroke and transient ischemic attacks hospitalized at the Department of Neurology in Novi Sad underwent examinations to detect a patent foramen ovale, which was found in 55.6% of patients with cryptogenic stroke. The average age of these patients was 30.6 years. Transcranial Doppler sonography showed 100% sensitivity and 100% specificity for the prediction of right-to-left shunts proven by transesophageal contrast echocardiography. Both positive and negative predictive values in our group of patients were 1. Transcranial Doppler with bubble test is a reliable method for the detection of a patent foramen ovale, with a high level of sensitivity and specificity which is comparable with transesophageal echocardiography. Moreover, it is cheaper and more comfortable than transesophageal echocardiography, and should be used routinely in neurological practice.
Intravenous Thrombolysis in Acute Ischemic Stroke. Acute ischemic stroke is a major cause of mortality and morbidity in the world. Intravenous thrombolysis with recombinant tissue plasminogen activator remains the standard treatment for acute ischemic stroke for any patient presenting within 4.5 hours from symptom onset. However, it is more effective and safe when treatment starts early. This therapy for acute ischemic stroke has been administered in Vojvodina since 2008. Various factors influence the outcome after intravenous thrombolysis. Timely recanalization and reperfusion is associated with better clinical outcomes. Mechanical Thrombectomy - a New Therapeutic Modality for the Treatment of Acute Ischemic Stroke. Nevertheless, the rate of recanalization and favorable outcomes for patients with acute ischemic stroke due to large vessel occlusion are low after intravenous thrombolysis. In such patients mechanical thrombectomy has demonstrated significantly higher rates of recanalization and improved outcomes compared with intravenous thrombolysis alone. This endovascular reperfusion therapy began to be implemented in Vojvodina in 2016. Conclusion. Intravenous thrombolysis continues to play a key role in the treatment of all acute ischemic stroke patients, but mechanical thrombectomy should be the ?gold standard? in the cases with large vessel occlusion.
SU M M A RYPeutz-Jeghers syndrome (PJS) is a rare genetic disorder with autosomal-dominant pleiotropic inheritance, variable penetrance and characteristic signs of the disease that predisposes persons to increased risk of developing cancer, particularly in the gastrointestinal tract and the breast. Due to genetic nature of disease, in the familial Peutz-Jeghers syndrome, a multiplication of symptoms in the three-generation family members was established. This paper represents an insight into the anamnesis of PJS in one family over thirty-seven years of follow-up, and is part of the broader study of this disorder. Article presents family history, clinical and histological findings and multiplication of symptoms of PJS across three generations.Over thirty-seven years, PJS has been present in this family in the form of only mucocutaneous pigmentation but without clinically manifested signs (father), or with both melanine hyperpigmentation and gastrointestinal hamartomatous polyposis (his daughter and her son).The symptoms rose suspicion of the existence of PJS complication, i.e. carcinoid-like syndrome with watery diarrheas accompanied by constipations in the affected mother and son who were surgically treated. Diagnosis of PJS was histopathologically confirmed in both cases: the presence of the polyps with hamartomatous pattern and conspicuous hyperplasia of chromogranin-positive (EC and L cells) and serotoninpositive (EC) cells. Malignant transformation of PJ-removed polyps was not found. Besides hamartoma, polyps as well as a tubular adenoma were found, with a low degree dysplasia without malignant transformation (son).The authors discuss the findings in relation to the important role of the gastrointestinal endocrine cell hyperplasia, not only for better understanding of the growth and clinical symptoms of the PJ polyposis, but also for new approach and the possible application of anti-hormonal therapy in the treatment of these patients in the future, that is not currently in use.
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